ABSTRACT
INTRODUCTION: Guillain-Barré syndrome can occur at any time of pregnancy with the same incidence as in the general population. Observations. We report two cases of patients who developed a progressive ascending paralysis during the second trimester of pregnancy. The worsening of the respiratory insufficiency for one of them required a transfer to an intensive care unit for artificial ventilation lasting 102 days. In the two cases, cerebrospinal fluid examination revealed albumin-cytological dissociation and repeated electrophysiological studies showed typical features of demyelinating neuropathy with conduction blocks. Biological investigations, especially CMV and Campylobacter jejuni serologies, were all negative. Intravenous immunoglobulin infusions, in one case associated with high doses of corticosteroïds, were ineffective. Rapid improvement was observed in the two patients after delivery. CONCLUSION: These cases raise the question of the relationships between the Guillain-Barré syndrome and pregnancy. The occurrence of the disease, as well as the rapid recovery in post-partum, could be consecutive to a partial failure of the maternal immunological tolerance toward the fetus.
Subject(s)
Guillain-Barre Syndrome/physiopathology , Pregnancy Complications/physiopathology , Adrenal Cortex Hormones/therapeutic use , Adult , Combined Modality Therapy , Disease Progression , Drug Resistance , Electromyography , Female , Fetus/immunology , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/immunology , Guillain-Barre Syndrome/psychology , Humans , Immune Tolerance , Immunoglobulins, Intravenous/therapeutic use , Neural Conduction , Postpartum Period , Pregnancy , Pregnancy Complications/immunology , Pregnancy Complications/psychology , Pregnancy Complications/therapy , Pregnancy Trimester, Second , Remission, Spontaneous , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapySubject(s)
Chylothorax/chemically induced , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Simvastatin/adverse effects , Aged , Asthenia/chemically induced , Back Pain/chemically induced , Biopsy , Bronchoscopy , Chylothorax/diagnostic imaging , Chylothorax/diet therapy , Cough/chemically induced , Diet, Fat-Restricted , Dyspnea/chemically induced , Humans , Hypercholesterolemia/drug therapy , Male , Tomography, X-Ray ComputedABSTRACT
We report a case of pleuro-pericarditis related to administration of isoniazid. Drug-induced lupus is well known; we recall the principle clinical, biological and immunological characteristics.